TITLE: Left Atrial Appendage Occlusion: Cost-Effectiveness in a Canadian Setting
Bibliographic record
Abstract
Atrial fibrillation (AF) is the most common form of cardiac arrhythmia, associated with high morbidity and mortality. 1,2 AF increases the risk of clot formation and stroke four- to five-fold across all age groups and is responsible for 10 % to 15 % of all ischemic strokes. 3 AF is the most common cause of stroke among the elderly, representing approximately 25 % of strokes in patients age ≥ 80 years. 4 Oral anticoagulants are currently used as the standard treatment to prevent stroke in AF patients. 5 These drugs have been shown to reduce the risk of thromboembolic events by 68 percent. 6 Despite the high efficacy of oral anticoagulants there are some concerns associated with the use of these drugs such as increased risk of bleeding and need for regular control of the International Normalized Ratio (INR). Furthermore, anticoagulation is contraindicated or considered to be risky in patients with hemorrhagic tendencies, acute pericarditis, or recent planned surgery of the eye or central nervous system, as well as in pregnant patients and those who are at an increased risk of a fall. 7,8 In about 90 % of AF patients stroke originates from thrombotic embolization due to the loss of atrial appendage contractility and emptying. 9,10 Therefore, closure of the left atrial appendage (LAA) has been suggested as an alternative to anticoagulant therapy for stroke prevention in AF patients. Different approaches have been utilized for exclusion of LAA from circulation: surgical ligation and or amputation of LAA in patients who undergo valvular open heart surgeries, thoracoscopic exclusion of LAA using an endoloop snare or staple, and percutaneous catheter-based procedures. 11-13 Several percutaneous catheter-based devices exist, including the PLAATO system (EV3
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.028 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.002 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.003 | 0.001 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.021 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".